Wen Bin-hong, Teng Wei-ping, Shan Zhong-yan, Li Yuan-bin, Li Jia, Gao Bo, Shang Tao, Zhou Jia-ren, Li Chen-yang, Zhou Wei-wei, Ding Bin, Ma Ying, Wu Ying, Liu Qun, Liu Wei, Yu Xiao-hui, Chen Yan-yan, Wang Wei-wei, Fan Chen-ling, Wang Hong, Guo Rui
Department of Endocrinology, Institute of Endocrinology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Nei Ke Za Zhi. 2008 Dec;47(12):1003-7.
To investigate the prevalence of gestational transient thyrotoxicosis (GTT) and analyze the cause of thyrotoxicosis encountered in this period.
An epidemiologic survey in ten hospitals in Shenyang was performed and 534 pregnant women during the first trimester of pregnancy filled questionnaire, received physical examination and had serum thyroid-stimulating hormone (TSH), free T(4) (FT(4)), free T(3) (FT(3)), thyroid peroxidase antibody (TPOAb), thyrotrophin receptor antibody (TRAb), and human chorionic gonadotrophin (hCG) tests.
(1) The total prevalence of thyrotoxicosis was 9.75% (52/534) in the first trimester and the prevalence of GTT was 7.86%, which accounted for 80.77% of the thyrotoxicosis encountered in this period. A total of 88.89% of the overt GTT showed only elevated FT(3) level. (2) The level of serum hCG increased gradually in the first trimester. The medians of hCG were 25 300, 85 220 and 81 780 IU/L 6, 8 - 10 and 12 weeks after gestation, respectively (P = 0.000). The medians of serum TSH were 1.45, 1.10 and 0.84 mIU/L 6, 8 - 10 and 12 weeks after gestation, respectively (P < 0.01). (3) When serum hCG was more than 50 000 IU/L, the prevalence of GTT increased obviously. When serum hCG was between 80 000 IU/L and 110 000 IU/L, subclinical GTT increased significantly. When serum hCG was more than 110 000 IU/L, overt GTT increased significantly. Correlation analysis showed that serum hCG was related negatively with TSH (r = -0.402, P = 0.000) and positively with FT(3) (r = 0.165, P = 0.000), but not related with FT(4).
The prevalence of GTT is 7.86% in the first trimester and it is the main cause of thyrotoxicosis found in the first trimester, accounting for 80.77% of all the causes. The serological characteristic of overt GTT is mainly the elevation of serum FT(3) level. Serum hCG level is related with the severity of GTT.
探讨妊娠一过性甲状腺毒症（GTT）的患病率，并分析此期甲状腺毒症的病因。
在沈阳的十家医院进行了一项流行病学调查，534例孕早期孕妇填写问卷、接受体格检查，并检测血清促甲状腺激素（TSH）、游离T4（FT4）、游离T3（FT3）、甲状腺过氧化物酶抗体（TPOAb）、促甲状腺激素受体抗体（TRAb）和人绒毛膜促性腺激素（hCG）。
（1）孕早期甲状腺毒症的总患病率为9.75%（52/534），GTT的患病率为7.86%，占此期甲状腺毒症的80.77%。88.89%的显性GTT仅表现为FT3水平升高。（2）孕早期血清hCG水平逐渐升高。妊娠6、8 - 10和12周时hCG的中位数分别为25 300、85 220和81 780 IU/L（P = 0.000）。妊娠6、8 - 10和12周时血清TSH的中位数分别为1.45、1.10和0.84 mIU/L（P < 0.01）。（3）当血清hCG超过50 000 IU/L时，GTT的患病率明显增加。当血清hCG在80 000 IU/L至110 000 IU/L之间时，亚临床GTT显著增加。当血清hCG超过110 000 IU/L时，显性GTT显著增加。相关性分析显示，血清hCG与TSH呈负相关（r = -0.402，P = 0.000），与FT3呈正相关（r = 0.165，P = 0.000），但与FT4无关。
孕早期GTT的患病率为7.86%，是孕早期发现的甲状腺毒症的主要原因，占所有病因的80.77%。显性GTT的血清学特征主要是血清FT3水平升高。血清hCG水平与GTT的严重程度相关。
